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Her Majesty's CIO braces US for Obama HIT

Health Info Tech? Good luck

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Her Majesty's Government Chief Information Officer, John Suffolk, says the US can expect a tough slog as it implements Barack Obama's Health Information Technology scheme.

Speaking this afternoon at a public-sector technology forum hosted by Wyse Technology in San José, California, Suffolk drew on his experience in setting up the UK National Health Service's information system. And from a San José conference room, it was difficult to tell what was reality and what was embroidery.

Referring to the integration and standardization of information from the federal down to the local level, he claimed that in the UK, "You can go into any one of our local authorities and get the same benefits you'd get in any of the other 399 because they're all connected up to the federal systems."

The reason for this integration is simple, he said. "Citizens neither know nor care what the dividing lines of government are. If you want to put food on the table for your children, you don't care who's providing that money. And our job is to make it absolutely seamless from a government's perspective."

And he made some rather bold claims about the availability of UK government services: "Every single thing that we need to do online is online. There is no transaction that a citizen cannot do online if they wish to do it online."

He did temper that boast with a bit of realism, saying that "Today it's very, very common in a rural area to speak a hundred different languages - in the city it's always been 150, 160 languages" before asking the assembled CEOs and CIOs, "How many of your websites are in 150 different languages?"

None, of course, raised a hand. Suffolk then commiserated, "Although we've put everything online, it's only to a segment of the population."

When a questioner ask what Suffolk's work with the NHS would lead him to advise the US, which is just beginning to construct a similar information system, Suffolk began sardonically: "First of all, let me just say 'Good luck!'"

He then went on to explain the scope of the challenge. "The NHS service, of which I am a fantastic fan, in the UK has 1.3 million public servants. I think it's the world's second-largest organization. And of course, it's not one organization. It's 30,000 organizations."

But according to Suffolk, the challenge of getting the NHS system up and running was not one of hardware and software. "The challenge is not technology - we've put the world's largest virtual private broadband network in," he said, going on to claim that "We have given citizens total choice and booking services, so that you can examine your doctor, examine the hospital, read the medical dictionaries. And it's all web 2.0 - [you can] listen to people who've had a knee operation or any other strange operation they may have had, check all the MRSA, success rates, failure rates, and then go and book - all online. The technology is relatively easy - it's just a scale issue."

The problem is people, their differing opinions on what should be shared, and - in some cases - their larceny. According to Suffolk, "The biggest issue is getting professionals to agree on what data they're going to share. 'Well, I don't think you should share any data on my customers, my clients.' Well, I want to have it all. 'Well, you can't.'

"So the challenge is actually...commonality of view in terms of what success looks like. What happens if people just say 'No!' because they can. Professional people can say 'No!' Citizens can say 'No!' Do all citizens want their information shared? What are you going to do if they say 'Well, no!'"

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